Keep your ears a 'swab-free' zone

The American Academy of Otolaryngology is urging you not to use cotton swabs to clean their ears. With the public going to the pool or the beach, keeping ears in a "swab-free zone" may be easier said than done. Dr. Howard W. Francis, an associate professor in the Johns Hopkins School of Medicine's Department of Otolaryngology - Head and Neck Surgery, explains the purpose of earwax, the potential damage caused by the use of cotton swabs and the safest alternatives for cleaning your ears:

•Earwax (cerumen) is produced by skin glands that line the outer third of the ear canal. This substance acts as a barrier to infection of the skin in the ear canal, and the absence of earwax can be an indication of local skin disease and increased susceptibility to bacterial invasion that results in "swimmer's ear."

•Some people produce excessive earwax, which may cause reversible hearing loss, ringing in the ear, ear pain, dizziness, itching and/or cough, particularly if water is trapped in the ear after swimming or bathing. There are no remedies available to reduce earwax production or accumulation.

•Earwax only needs to be removed if it produces symptoms or impedes your doctor's view of the eardrum. Attempts to remove wax at home should be limited to wiping it away at the opening without insertion of cotton swabs or other objects into the ear canal. This can cause a perforation of the eardrum and threaten hearing function, trauma to the ear canal skin and provide opportunity for bacteria to invade the tissues to produce outer-ear infections.

Most importantly, using swabs and other objects within the ear canal can push the wax deeper within the canal, even against the ear drum, making subsequent removal more difficult and potentially traumatic. Over-the-counter products that soften earwax combined with irrigation are good ways to clean the ear and it can be done by anyone. This approach is, however, discouraged in children.

•In cases of excessive earwax, your medical provider may remove the wax with a curette, irrigation or a suction device. Earwax removal by an otolaryngologist using instruments under direct visualization through an otoscope or microscope may need to be repeated on a regular basis to prevent impactions in susceptible patients. This is particularly important for people who depend on hearing aids. .

•People must take great caution when treating their ear canals. If not, they can develop infection, pain, ringing in the ear or eardrum rupture. Rarely, patients can develop abnormal heart rhythms due to the nerve supply of the ear canal.